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   2015| October-December  | Volume 4 | Issue 4  
    Online since December 14, 2015

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Scrotal leiomyoma
Gayatri Devi Parasa, Mark Ruth Prasanna, Satyaprakash Venkatachalam Turlapati
October-December 2015, 4(4):263-265
Leiomyomas are benign tumors of smooth muscles. Leiomyoma of the scrotum, also known as genital leiomyoma, is a rare entity. Smooth muscle tumors arising in the scrotum are a specific and rare group of cutaneous tumors. We report a case of genital leiomyoma in a 55-year-old male who presented with a scrotal nodule. The mass was excised and sent for histopathological evaluation with a provisional diagnosis of sebaceous cyst. Light microscopy and immunohistochemical findings were consistent with leiomyoma.
  1 1,983 296
Double heterozygous HbQ India/HbD Punjab hemoglobinopathy: A rare case report
Sujani C Madabhushi, Uma Swarup Nugoori, Kiran Kumar Doppalapudi, Mukesh Agrawal
October-December 2015, 4(4):266-268
Hemoglobinopathies constitute the most common genetic diseases in the world. In India, both beta-thalassemia and structural hemoglobin variants, such as hemoglobin S (HbS), hemoglobin D (HbD), and hemoglobin E (HbE), are common and pose significant health problem, these variants show heterozygous state along with beta-thalassemia. Compound heterozygosity among hemoglobin variants is very rare. Cation-exchange high-performance liquid chromatography (CE HPLC) provides accurate and reliable diagnosis of various hemoglobin variants. Here, we report an index case of double heterozygous hemoglobinopathy, hemoglobin Q (HbQ) India/HbD Punjab (ααQ India-ββD Punjab) using CE HPLC. This is the fifth report of double heterozygosity for HbQ India/HbD Punjab globally and fourth case report from India to the best of our knowledge.
  1 2,276 175
Duplication of gallbladder: A rare congenital malformation
Onteddu Joji Reddy, Jamkhana Abdul Gafoor, Balla Suresh, Polysetty Obuleswar Prasad
October-December 2015, 4(4):269-271
Gallbladder duplication is a rare anatomic malformation, which can now be detected by preoperative imaging study. We report a case of a symptomatic duplicated gallbladder, successfully treated by laparoscopic cholecystectomy. This anomaly is important for surgeons to know because of the associated anatomical variations of the main bile duct and hepatic artery and increased risk of common bile duct injury.
  1 3,516 236
Total pancreatic lipomatosis: A rare presentation
Onteddoo Joji Reddy, Jamkhana Abdul Gafoor, Gongalareddy Mohan Reddy, Polysetty Obuleswar Prasad
October-December 2015, 4(4):272-274
Fatty replacement of the pancreatic parenchyma after chronic pancreatitis is not uncommon, and it may be focal or diffuse. Usually in chronic pancreatitis patients, atrophy of the parenchyma occurs followed by fat infiltration. In this case report, the patient had total fatty replacement of the entire pancreatic parenchyma with multiple calculi at the head of pancreas and in pancreatic duct at tail secondary to chronic pancreatitis, without exocrine and endocrine deficiency manifestations, which simulates a rare disease lipomatous pseudohypertrophy of pancreas.
  1 3,185 187
Primary intraosseous squamous cell carcinoma arising from keratocystic odontogenic tumor: CK 17 evaluation
Rashmi Metgud, Bhagwandas A Rai, Bipin A Bulgannawar, Kanupriya Gupta
October-December 2015, 4(4):275-279
Primary intraosseous squamous cell carcinoma (PIOSCC) derived from an odontogenic keratocyst (OKC) is a rare malignant neoplasm of the jaws, which is locally aggressive, with predominantly poor prognosis. The number of well-documented cases of PIOSCC ex OKC is extremely small; thus sufficient incidence data are not available in the literature. Overall and disease-free survival is poor, with almost 50% patients failing to survive within the first 2 years of follow-up, and this can be attributed to the delayed diagnosis. Knowledge of the clinical, radiographic, and histopathologic features of primary intraosseous squamous cell carcinoma (PIOSCC) allows accurate diagnosis and appropriate treatment of this rare malignancy.
  1 3,584 216
Perceived stress and prevalence of depression among first-year medical students
Endreddy Ananda Reddy, Venkata Venu Gopala Raju Srijampana, Bhagawan Rajana, Sri Sai Tejaswini Muddana
October-December 2015, 4(4):209-213
Background: Modern life is full of hassles, deadlines, frustrations, and demands. For many people, stress is so common that it has become a way of life. Stress is not always bad. In small doses, it can help a person perform and motivate to do the best. Procuring medical degree is a tedious job. People undergo enormous stress during the course of medical education. Aims: Our study was aimed to explore the patterns of stress perceived and the prevalence of depression among first-year medical students. Materials and Methods: A cross-sectional study was performed on first-year medical students by using the Perceived Stress Scale (PSS) and Zung Self-Rating Depression Scale (ZSRDS) to assess the level of perceived stress and depression, respectively. The data were tabulated using MS Excel sheet and were analyzed using Statistical Package for the Social Sciences (SPSS) version 16. The difference in the patterns of perceived stress and prevalence of depression among males and females was analyzed by Chi-square test. Results: Among the study sample of 143 medical students, 58% of the students were females and 42% were males. Out all the subjects, 3.5% students scored in low stress group, 21.7% students scored in average stress, 38.5% students scored in the group of high stress, and 35.7% students scored in very high stress group. The level of perceived stress was higher in females. The number of students who scored in mild depression was 7.7% and the number of students who scored in moderate depression was 1.4%. Statistically significant correlation was observed between the high stress and prevalence of depression. Conclusion: Our study pointed out the need of providing attention to medical students during their entire tenure, especially during exams.
  1 4,463 482
Comparison of frictional resistance between various bracket types and archwire materials ligated with low-friction and conventional elastic ligatures
Vasu Murthy Sesham, Anupriya Jaitly, Lalitha Chigurupati, Praveen Kumar Neela, Pavan Kumar Mamillapalli, Revathi Peddu
October-December 2015, 4(4):246-252
Background: Friction plays a very crucial role in our daily life and orthodontics is no exception. Various materials possess friction of varying intensity, which ultimately affects tooth movement. Aim: The aim was to compare the frictional resistance (FR) between various bracket types and archwire materials when ligated with low-friction and conventional elastic ligatures so as to obtain best bracket-archwire combination possessing least FR for clinicians in achieving optimal mechanotherapy. Materials and Methods: Study consisted of three types of preadjusted edgewise brackets including ceramic, stainless steel (SS) and self-ligating brackets (0.022" slot, MBT prescription), two types of archwire materials, 0.019 × 0.025" SS and 0.019 × 0.025" Teflon coated (TC) and two types of ligatures including low-friction and conventional elastic ligature. A total of 10 combinations were formed with the above mentioned material. Each combination was tested 10 times on universal testing machine for FR. The data was statistically analyzed using one-way ANOVA and unpaired t-tests. Results: Self-ligating brackets exhibited least FR (2.35 ± 0.15N) followed by metal brackets. Ceramic brackets showed the highest FR (7.32 ± 0.10N). In general, the mean value for TC wire was less than that of SS wire indicating low FR possessed by TC wires. Results also showed that low-friction ligatures produce lower-friction when compared with conventional elastic module (P > 0.05). Conclusion: The study demonstrated that self-ligating brackets with TC wire showed the least FR and ceramic brackets with SS wire when ligated with conventional elastic ligature showed the highest FR.
  1 3,157 354
A rare presentation of posterior fossa epidermoid: With acute bleed
Sandeep Talari, Satya Varaprasad Kadali, Vijay Kumar Pallikonda
October-December 2015, 4(4):280-281
A 13-year-old female presented with sudden onset of severe headache and altered sensorium. Computed tomography (CT) scan showed a hyperdense midline mass in the posterior fossa. At preoperative diagnosis, the mass was thought to be a hemangioblastoma or pilocytic astrocytoma with bleed. Operative findings and histological examination revealed spontaneous bleed into epidermoid cyst. This uncommon presentation of intracranial epidermoid cyst has prompted us to report the case.
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Radicular dentin dysplasia: A case report
I Hemachandrika, J Sharada Reddy, K Suhasini, P Tarasingh
October-December 2015, 4(4):282-285
Dentin dysplasias form a rare group of hereditary dentin malformations characterized clinically by normal appearing crowns but extreme mobility of teeth due to defective root formation. Both deciduous and permanent teeth may be affected. Delayed eruption and malocclusion may be associated features. This disorder is broadly classified into two types: Type I (radicular dentin dysplasia) and Type II (coronal dentin dysplasia). Type I is more common and is known by the term "rootless teeth." The difficulties encountered with rootless teeth are obvious: there is no anchorage, there is compromised blood supply, deranged homeostatic mechanisms of the tooth as well as overload of masticatory and other stresses on the crowns leading to their early exfoliation. This paper discusses a case report of Type I dentin dysplasia and attempts to project the existing data in a concise form.
  - 2,307 181
Lower incisor extraction: Can it be justified? A report of two cases
Kalyani Mallavarapu, Revathi Peddu, Syagamreddy Rama Koteswara Reddy, Sai Prakash Adusumilli
October-December 2015, 4(4):286-290
Extraction versus nonextraction debate is still continuing since 1900s. Some cases demand extraction of premolars, but the decision making is difficult in the border line cases with good facial esthetics. Lower incisor extraction becomes a therapeutic alternative to premolar extractions in lower anterior crowding cases with good facial esthetics and well occluded posterior teeth. Diagnostic setup reveals the posttreatment occlusal possibilities and hence the most important step in the diagnosis and treatment planning of these cases. Lower incisor extraction decision would be a better option in cases with anterior Bolton's discrepancy. Two cases treated with single lower incisor extraction, indications, contraindications and measures to attain posttreatment stability are discussed in this presentation.
  - 8,559 582
Evaluation of salivary albumin in diabetic children
Syed Shahbaz, Girish Katti, Sreenivas Rao Ghali, Chandrika Katti
October-December 2015, 4(4):253-256
Aim: To evaluate salivary albumin in insulin-dependent diabetes mellitus (IDDM) patients and to compare with the healthy nondiabetic control group. Study Design: The study consisted of 30 IDDM patients and 30 age- and sex-matched healthy controls. All the subjects were subjected to salivary albumin estimations. The salivary albumin estimations were done by bromocresol green (BCG) dye method, end point. All the estimations were performed using an AutoAnalyzer. Results: The results showed elevated levels of salivary albumin in the IDDM group compared to the healthy controls. Conclusion: The salivary albumin can be used to assess the metabolic status of the diabetic subjects since it showed increased levels compared to the healthy controls. Salivary parameters can act as adjuncts in assessing the overall metabolic status of the patient.
  - 2,092 163
Negative pressure wound therapy in orthopaedic post operative infections: Role in implant retention and dead space management
Nanda Kishore Maddineni, Satya Kumar Koduru, Harshavardan Surath, Ananda Rao Venkata Dakshina Murthy, Mettu Rami Reddy, Amarnath Surath
October-December 2015, 4(4):257-262
Introduction: Postoperative orthopedic infections in the presence of implants require timely and aggressive intervention for eradication of infection. Negative pressure wound therapy (NPWT) is beneficial in wound management and implant retention, ultimately leading to fracture union. Incidentally, the use of NPWT was of great help in reducing dead space, which is responsible for the chronicity of the infection. It results in collapse of the cavity without need for repeated debridement. Aims and Objectives: This study is done to evaluate the role of negative pressure wound therapy in orthopaedic post operative infections and it's role in implant retention and dead space management. Materials and Methods: Thirty-four patients who developed postoperative infections are included in the study. After thorough wound lavage NPWT dressing was applied followed by wound closure either by secondary suturing, skin graft or flap cover. Results: Thirty-four patients were treated during 2012-2014 out of which 22 patients had implants, 2 were treated for dead space, and 10 for both. Conclusion: NPWT has a definite role in eradicating early postoperative infection in the presence of an implant. The greatest advantage is retention of the implant.
  - 2,578 240
Vitreous potassium concentration as a predictor of postmortem interval: A cross-sectional study among poisoning and burns cases at a tertiary care center in rural Haryana
Rajesh Duraisamy Rathinam, Abhishek Singh, Pooja Goyal, Virender K Chhoker, K Jayaprakash, Shwetank Goel, Pankaj Chikkara
October-December 2015, 4(4):214-218
Background: Time since death (TSD) is an important parameter to the forensic expert. Only a few studies are available in the literature to determine the relationship between vitreous K + concentration and TSD, especially among poisoning and burns cases, and thus information on the same is scant. Therefore the present study was planned. Objective: The main objective was to determine the relationship between changes in vitreous K + concentration with increasing TSD among poisoning and burns cases. An additional objective was to derive a formula for determining TSD from changes in levels of vitreous K + in the study subjects. Materials and Methods: In this study, autopsy cases brought to the mortuary of the Department of Forensic Medicine and Toxicology of a tertiary care center were subjected to collection of vitreous humor for the determination of vitreous K + . Data of 36 cases where autopsy confirmed the cause of death as poisoning or burns were included in this study. Determination of K + level in the collected samples was done by the ion-selective electrode method (Biolyte 2000 autoanalyzer). Results: A linear relationship was observed between vitreous K + concentration and TSD in both the eyes. External factors such as seasonal variations and temperature, gender difference, and age had no appreciable effect on the concentration of vitreous K + in either eye. In this study the linear regression equations obtained from potassium concentration (y) versus time (x) for the two groups among poisoning and burns cases were as follows. For right eye: Regression line (y) = -4.932 x + 1.932; for left eye: Regression line (y) = -5.380 x + 1.990. The K + levels were found to increase up to 40 h after death. Conclusion: This study highlighted the usefulness of the relationship between vitreous potassium concentration and TSD in both the eyes. The formula calculated from the current study could prove to be more appropriate as it is based on more reliable tests.
  - 2,370 212
A study on the role of vamanam on serum bilirubin and calcium levels
Vijaya Lakshmi Narra
October-December 2015, 4(4):219-223
Introduction: Normal pitta maintains normal hepatic metabolism. Serum bilirubin and calcium levels are associated with hepatic function. Vamanam and Sweda Karma increase agni, which in turn affects the liver metabolism. The raised agni after sweda and vamanam increase the metabolic activity of the body. Today's quality of food and dietary habits, lifestyle, and changes in seasons are often the cause of saturation of toxins in the body, which according to Ayurveda are malas and aam, and these are also the cause for vitiation of the doshas. When the body becomes free from this malas, aam (toxic materials), and vitiated doshas, a state of good health can be achieved. Ayurveda has the best therapies in the form of Panchakarma to make the body free from these disease-causing factors. Aim: Is to study on the role of vamanam on serum bilirubin and calcium levels. To study the bodily changes after Vamana Karma. Materials and Methods: 40 patients of Tamakaswasa and Sidhma Kushta divided into two group each consisting of 20 patients. The treated group patients were divided into 10 each of Tamakaswasa and Sidhma Kushta managed with Snehapana, Sweda Karma and finally with Vamana Karma. Effects of Snehapana, Sweda and Vamanam on serum bilirubin, calcium were evaluated before treatment, after Sneha, Sweda and at the end of the treatment. Results: Marginal changes seen in this study. 85% symptoms relieved in both the diseases. Conclusion: Vamana can improve the functional and metabolic activities of the body. The clinical signs and symptoms were decreased after Vamana Karma.
  - 3,296 263
Maternal left ventricular systolic and diastolic function during second trimester of pregnancy with preeclampsia
Padmaja Tangeda, Neerja Shastri
October-December 2015, 4(4):224-228
Objective: This study was done to assess maternal cardiovascular function using echocardiography in normal and preeclamptic women in the second trimester of pregnancy. Materials and Methods: This cross-sectional study was conducted at Prathima Institute of Medical Sciences (PIMS), Karimnagar, Telangana, India between February 2012 and October 2013. Doppler echocardiography was performed in 15 normotensive controls (Group I) and 15 pregnant women with hypertension (Group II) at 20-24 weeks of gestation. Baseline characteristics and maternal and fetal outcome were studied with systolic and diastolic parameters on echocardiography. Results: The following parameters were higher in preeclamptic subjects as compared to normotensive controls: Mean cardiac output (CO) (6642 ± 1508 mL/min vs 5175 ± 1279 mL/min); mean left ventricular (LV) mass, I.E., LVM (121.15 ± 16.55 g vs 104.90 ± 23.17 g); total vascular resistance (TVR) (1286.85 ± 106.2 dyn.s/cm 5 vs 1236.5 ± 68.18 dyn.s/cm 5 ). Women with preeclampsia delivered smaller babies (2510 ± 200.16 g) as compared to normotensive controls (2895 ± 276.20 g). Student's t-test was used as a test of significance. Conclusion: Women with preeclampsia in the second trimester have significantly high CO and systolic and diastolic dysfunction compared to normotensive controls. Blood pressure (BP) monitoring alone is insufficient to effectively identify the risk of cardiovascular complications in these subjects. Echocardiography is a noninvasive method to evaluate the maternal hemodynamic during the second trimester and can help to identify high-risk patients before development of preeclampsia, and thus it may improve the outcome of pregnancy.
  - 2,560 250
Clinical and radiographic evaluations of porous hydroxyapatite as bone graft material in the treatment of interproximal vertical defects
Dandu Subramanyam Madhu Babu, Kankara Vinathi Reddy, Anumala Deepa, Shobha Patil, Vandana , Ravindra Reddy Nagireddy
October-December 2015, 4(4):229-235
Background: Periodontal regeneration has been the goal over the past few years in the treatment of various periodontal defects. Various traditional surgical and nonsurgical approaches were found to produce the minimal amount of new periodontal attachment apparatus. It was further suggested that the addition of various graft materials might increase the amount of new bone, periodontal ligament, and cementum generated. Hence, this clinical study was undertaken to evaluate the efficacy of porous hydroxyapatite in the treatment of interproximal vertical bony defects in human beings as a regenerative implant material. Materials and Methods: A total of 16 sites from eight patients in the age group of 30-60 years were selected. Out of the two sites from each patient, one was control site-flap surgery without porous hydroxyapatite graft material and the other was experimental site-flap surgery with porous hydroxyapatite graft material. At 3 months, 6 months, and 9 months postoperatively, each site was subjected to clinical parameters such as pocket depth, attachment gain, gingival recession, and osseous fill. Results: Significant mean attachment gain was observed at 6 months and 9 months after surgery. The mean original defect was significant at 3 months and 6 months postsurgically. Mean percentage fill was significant at 3 months postsurgically. All other parameters were nonsignificant. Conclusion: Radiographic assessment showed a greater defect fill at the grafted site indicating the superiority of grafting procedure to nongraft procedure. Hence, porous hydroxyapatite crystals are an effective graft material in elimination of interproximal vertical defects.
  - 2,293 174
Comparison of patient sensitivity using dentin bonding agent versus zinc phosphate base beneath the amalgam restorations: An in vivo comparative study
Sarjeev Singh Yadav, Jagadeeswara Rao Sukhabogi, Vemala Bharath Kumar, Muralikrishnam S Raju, Venkat V Giri, Gopi Pulivarthi
October-December 2015, 4(4):236-240
Aim: The aim of the present study is to evaluate and compare patient sensitivity following the amalgam restorations using two different materials beneath them - zinc phosphate base and dentin bonding agent. Materials and Methods: Thirty individuals aged between 20 years and 60 years were selected who presented with two class I carious lesions located in different quadrants. Both the teeth were filled at the same appointment. Following rubber dam isolation, conventional cavities were prepared for the amalgam restorations. One tooth received zinc phosphate base while the other received dentin bonding agent beneath the amalgam restoration. High copper non-γ2 amalgam was triturated using amalgamator by condensing it into the cavity. Questionnaires were given to the patients for recording sensitivity scores to heat, cold, or biting at the end of 1, 3, 7, and 14 days. Results: Significance was determined based on the P values obtained from the simple curve z-test. On day 1, when groups I and II were compared, no significant difference in number of patients reporting postoperative sensitivity was found. On day 3, more number of patients reported sensitivity with zinc phosphate cement compared to those with dentin bonding agent. On day 7, there was great reduction in sensitivity in both groups compared to day 1 and day 3 but comparatively more in teeth with zinc phosphate base. On day 14, there was no significant sensitivity in both groups, patients showing no sensitivity to both zinc phosphate base and dentin bonding agent. Conclusion: Postoperative sensitivity was relatively more in teeth restored with zinc phosphate base compared to that restored with dentin bonding agent. Postoperative sensitivity resolved earlier in restorations with dentin bonding agent compared to zinc phosphate base, and sensitivity resolved with time in both the restorations.
  - 1,982 148
Psychological stress: Its effect on periodontal status of individuals
Gagan R Jaiswal, Shradha G Jaiswal
October-December 2015, 4(4):241-245
Background: Periodontitis is the inflammation and infection of the tissues that support the teeth. Growing evidence suggests that the psychosocial factors such as stress, depression, and level of social support provoke changes in host defense mechanisms that modify the disease process. Aims: This study aimed to determine if any correlation existed between social support, stress, and periodontal status of individuals. Materials and Methods: A cross-sectional study was carried out on 630 subjects (aged 25-70 years) suffering from chronic periodontitis. Questionnaire was the primary tool for data collection. Oral hygiene status and periodontal status were assessed using plaque index and clinical attachment level. Results: The data were analyzed by using statistical software Statistical Package for the Social Sciences (SPSS) version 17.0. Periodontitis showed a significant correlation with work tension, economic problems, plaque index, and unsecured job. Conclusion: Stress is an important risk factor for periodontal disease and has a confounding effect in presence of plaque on the periodontal status. We suggest that patients who are under stress should be provided meticulous periodontal care to avoid worsening of periodontal disease.
  - 2,689 341
Helicobacter pylori and its orodental implications: A review
Sri Lalitha Kaja, Kiran Kumar Kattappagari, Raviteja Chitturi, Lingamaneni Prashanth, Baddam Venkata Ramana Reddy
October-December 2015, 4(4):203-208
Helicobacter pylori (H. pylori) is a Gram-negative, microaerophillic, spiral bacterium. The prevalence of H. pylori infection was estimated to range from 40% to 80% and it varies widely. The advancement of biochemical techniques provided new information about the pathogenicity and virulence factors of H. pylori indicating a complex interaction of bacterial and host factors for infection by H. pylori. It is regarded as a serious and transmissible infectious disease linked to duodenal and gastric ulcers, gastric carcinoma, and also as a cofactor in the recurrence of aphthous ulceration. This article focuses on the pathogenesis, disease associations, and the orodental implications of H. pylori.
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